The Endocrinologist | Issue 99 [PDF] - Society for Endocrinology

ISSN 0965-1128 (print)ISSN 2045-6808 (online)T H E N E W S L E T T E R O F T H E S O C I E T Y F O R E N D O C R I N O L O G Y • I S S U E 9 9 SPRING 2011Libelliable forreform?PLUSWhy chooseendocrinology?AUTUMNENDOCRINERETREAT –WISH YOUWERE HERE?The LittleMester ofSheffieldCaution!

Nominations Committeein the spotlightFollowing an internal review conducted in 2010, we are pleased toannounce the revamp of the Nominations Committee. The newNominations Committee now incorporates the functions of the AwardsCommittee and aims to be proactive in:the selection process to ensure relevant expertise and experience isrepresented on Council and all other committees; this process will applyequally to the Society’s prizes, medals and awards. The committee feels it isparticularly important to encourage and support younger members to joincommittees, gain experience and thereby develop their careerputting forward members for the many external prizes and awards thatare availableChaired by Professor John Wass, the committee is comprised of eminentbasic science and clinical endocrinologists.We welcome all members’ views regarding nominations: please contactjulie.cragg@endocrinology.org if you have any names you wish to put forward.Who merits a Medal in 2013?The Society awards several medals annually, in recognition of outstandingcontributions to endocrinology. All members are invited to makenominations for the 2013 awards. Nomination forms are included in thismailing and can be found at www.endocrinology.org/about/medals.html.Please return them by 16 May 2011.The Dale Medal is the highest accolade bestowed by the Society and isawarded to an individual whose studies have changed our understanding ofendocrinology in a fundamental way. Previous recipients include KS Korach,ER Simpson, S O’Rahilly, M Thorner, AS McNeilly, S Lamberts, JK Findlay andR Kahn. The Society Medal is awarded to an endocrinologist working in theUK, in recognition of outstanding studies. It has previously been awarded toIS Farooqi, GR Williams, W Arlt, A Hattersley, HOD Critchley, BR Walker,VKK Chatterjee and JMC Connell.The other medals are intended to promote links between the UK and differentareas of the globe. The European Medal, presented to an endocrinologist inmainland Europe, has previously been awarded to JJ Holst, X Bertagna, B Allolio,W Wiersinga, N Skakkebaek, AM Colao, C Strasburger and A Maggi. TheHoffenberg International Medal (formerly known as the Asia and Oceania Medaland the International Medal) is awarded to an endocrinologist from outside theUK, to promote international collaboration. Previous recipients include G Karsenty,PJ Fuller, T Yoshimura, M Kawata, K Ho, K Morohashi, G Risbridger andK Kangawa. The Transatlantic Medal is awarded to an endocrinologist working inNorth America, and has previously been received by P Sassone-Corsi, JJ Kopchick,S Melmed, L Jameson, R Rosenfeld, B Spiegelman, DJ Mangelsdorf and K Korach.CONGRATULATIONSWe congratulate Mrs Nikki Kieffer, Chair of the Nurse Committee, who hasbeen awarded the 2010 British Thyroid Foundation Evelyn Ashley SmithAward for nurses with a special interest in thyroid disorders. The award willbe used to fund a project entitled ‘Thyroxine replacement in pregnancy andpre-conception: an audit of patient and GP knowledge of guidelines andcurrent clinical practice in Leicestershire’.Congratulations are also due to Professor Jeff Pollard of the Albert EinsteinCancer Center, New York, who has been awarded the American Cancer SocietyMedal of Honour for Basic Science for his work on the role of macrophages incancer. The Medal of Honour is the American Cancer Society's highest award.CALL FORCOMMITTEENOMINATIONS …If you would like to be involvedin the running of the Society, pleaseconsider standing for election.We welcome nominations from allmembers for the committees below.The term of office for newcommittee members is 1 January2012 for a period of 4 years.Clinical CommitteeTwo new members are sought.Finance CommitteeOne new member is sought for thiscommittee. Nominees must haveexperience of operating a largebudget and a sound knowledge ofinvestments and managementaccounts. A good understanding ofthe Society’s activities and ethos isrequired. If you would like to beconsidered for election, and wouldlike further details, please contact PatBarter, Finance Director, in the Bristoloffice (finance@endocrinology.org).Nurse CommitteeReplacements are sought for twomembers.Programme CommitteeFour new members are sought.Public Engagement CommitteeReplacements are sought for fourmembers.Science CommitteeFour new members are sought.Please see www.endocrinology.org/about/committee.html for moreinformation.SOCIETY CALENDAR11–14 April 2011Society for Endocrinology BES 2011ICC, Birmingham, UK19–20 September 2011Endocrine Nurse UpdateStratford-upon-Avon, UK14–16 October 2011Autumn Endocrine Retreat 2011Milton Hill Hall, Oxfordshire, UK7–9 November 2011Clinical Update 2011Hilton Hotel, Sheffield, UKWith regretWe are sorry to announce the deathof Senior Member Dr A Dewar MBET H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 13

NEW EDITOR-IN-CHIEF FORENDOCRINE-RELATED CANCERWe are delighted to announce that Professor Charis Eng, at the Cleveland Clinic, USA, succeededDr Jim Fagin as Editor-in-Chief for Endocrine-Related Cancer (ERC) in January 2011.Professor Charis Eng is the Chair and foundingDirector of the Genomic Medicine Institute of theCleveland Clinic, and the founding Director of theinstitute’s clinical component, the Center forPersonalized Genetic Healthcare. She is Professor andVice Chair of the Department of Genetics at CaseWestern Reserve University School of Medicine,Professor of Molecular Medicine at the Cleveland ClinicLerner College of Medicine, member of ClevelandClinic’s Taussig Cancer Institute and of the CASEComprehensive Cancer Center. She continues to hold anhonorary appointment at the University of Cambridge.Professor Eng holds the Sondra J and Stephen R HardisEndowed Chair in Cancer Genomic Medicine and theAmerican Cancer Society Clinical Research Professorship.More recently, she was elected to the Institute ofMedicine of the US National Academies.Professor Eng’s research interests can be broadlycharacterized as clinical cancer genetics translationalresearch. Her work on RET testing in multiple endocrineneoplasia type 2 and the characterization of thewidening clinical spectra of PTEN mutations have beenacknowledged as the paradigm for the practice of clinicalcancer genetics. In the clinic,Professor Eng is acknowledged asone of the rare ‘go to’ people onhow to implement genetic andgenomic-informed personalizedhealthcare. Professor Eng hasreceived numerous awards andhonours including the DorisDuke Distinguished ClinicalScientist Award, 2005 ATA VanMeter Award, and the 2006Ernst Oppenheimer Award ofThe Endocrine Society.Professor Eng grew up in Singapore and Bristol, UK,entering the University of Chicago at the age of 16. Aftercompleting an MD and PhD at the Pritzker School ofMedicine, she specialized in internal medicine at BethIsrael Hospital, Boston and trained in medical oncology atHarvard’s Dana-Farber Cancer Institute, Boston. She wasformally trained in clinical cancer genetics at theUniversity of Cambridge and the Royal Marsden, UK, andin laboratory-based human cancer genetics by ProfessorSir Bruce Ponder. At the end of 1995 Professor Engreturned to the Dana-Farber Insititute as AssistantProfessor of Medicine, and in 1999 was recruited by TheOhio State University as Director of the Clinical CancerGenetics Program. In 2002, she was promoted toProfessor and Director of the Division of Human Genetics,and was conferred the Klotz Endowed Chair. She wasrecruited by the Cleveland Clinic in September 2005.Professor Eng has broad editorial experience, asNorth American Editor of Journal of Medical Genetics(1998–2005), Senior Editor of Cancer Research(2004–2009), Associate Editor of Journal of ClinicalEndocrinology and Metabolism (2005–2009), and AssociateEditor of American Journal of Human Genetics (2007–2009).Professor Eng completed a 3-year term on the Board ofDirectors of the American Society of Human Genetics, a2-year term as Chair of the Clinical Science Committee ofthe Personalized Medicine Coalition and is serving a5-year term on the Board of Scientific Directors of theNational Human Genome Research Institute. She has alsobeen appointed to the US Department of Health andHuman Services’ Secretary’s Advisory Committee onGenetics, Health and Society (2009–2011) and is currentlyco-chair of this committee’s task force to examine wholegenome sequencing for clinical application.ERC also moves to six issues a year (bimonthly) fromFebruary 2011.IMPORTANT – 2011 SCE date changeThe registration and examination dates of the 2011 Specialty Certificate Examination (SCE) in Endocrinology andDiabetes have changed. The examination will now take place on 1 June 2011 (previously 15 June). Entrants areeligible to sit the exam during higher specialty training after entering ST3, although it is recommended that theywait until their penultimate year of training.Registration for UK candidates: 2 February–27 April 2011 Examination date: 1 June 2011Trainees who pass the exam will be awarded a Certificate in Endocrinology and Diabetes. Trainees who gainthe Certificate in Endocrinology and Diabetes and who are recommended for a Certificate of Completion ofTraining (CCT) will be entitled to apply for the postnominal MRCP(UK) (Endocrinology and Diabetes). For furtherinformation see www.mrcpuk.org/SCE/Pages/ExamDates.aspx.174 candidates sat the endocrinology and diabetes examination in 2010 with 86.7% of the UK trainees passingthe examination (this was the fourth highest pass rate of all specialities). The overall pass rate for the 174 candidateswas 69.5%. Comparisons with the other specialties can be found at: http://www.mrcpuk.org/SCE/Pages/Results.aspx.4 T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

Hypogonadism – an endocrine issue which causes significant morbidity and substantial reduction in quality of life 1CcontrolconcentrationcostCconvenienceTostran ® – a simple solution to a serious problemControl• Tostran ® returns and maintains hypogonadal patients T levels to normal 2• The metered dose system allows for easy dose titrationConcentration• Tostran ® is the only 2% testosterone gelCost• Tostran ® represents at least a 17% cost saving compared to Testogel ® across thedose range and at average daily doses 2,3,4,5Convenience• Tostran ® – easy to use, metered dose canister 6The first metered dose2% testosterone ge lA simple solution to a serious problemTostran Abbreviated Prescribing InformationTostran (testosterone) 2% Gel Prescribing InformationPlease refer to Summary of Product Characteristics (SPC) before prescribing.PresentationTostran 2% Gel, contains testosterone, 20 mg/g.IndicationsReplacement therapy with testosterone for male hypogonadism whentestosterone deficiency has been confirmed by clinical symptoms and laboratoryanalyses.PosologyThe starting dose is 3 g gel (60 mg testosterone) applied once daily atapproximately the same time each morning to clean, dry, intact skin, alternatelyon the abdomen or to both inner thighs. Adjust dose according to clinical andlaboratory responses. Do not exceed 4 g of gel (80 mg testosterone) daily.Patients who wash in the morning should apply Tostran after washing, bathingor showering. Do not apply to the genitals. Do not use in women, or childrenunder the age of 18 years.ContraindicationsKnown or suspected carcinoma of the breast or the prostate; hypersensitivity toany of the ingredients.Special warnings and precautions for useTostran should not be used to treat non-specific symptoms suggestive ofhypogonadism if testosterone deficiency has not been demonstrated and ifother aetiologies responsible for the symptoms have not been excluded. Notindicated for treatment of male sterility or sexual impotence. All patientsmust be pre-examined to exclude a risk of pre-existing prostatic cancer.Perform careful and regular monitoring of breast and prostate. Androgensmay accelerate the development of subclinical prostatic cancer and benignprostatic hyperplasia. Oedema with/without congestive heart failure may bea serious complication in patients with pre-existing cardiac, renal or hepaticdisease. Discontinue immediately if such complications occur. Use with cautionin hypertension as testosterone may raise blood pressure. Use with caution inischemic heart disease, epilepsy, migraine and sleep apnoea as these conditionsmay be aggravated. Care should be taken with skeletal metastases due to riskof hypercalcaemia/hypercalcuria. Androgen treatment may result in improvedinsulin sensitivity. Inform the patient about the risk of testosterone transferand give safety instructions. Health professionals/carers should use disposablegloves resistant to alcohols.InteractionsWhen androgens are given simultaneously with anticoagulants, theanticoagulant effect can increase and patients require close monitoring of theirINR. Concurrent administration with ACTH or corticosteroids may increase thelikelihood of oedema and caution should be exercised.Undesirable effectsVery common (1/10): application site reactions (including paresthesia,xerosis, pruritis, rash or erythema); common (1/100,

SOCIETY FACEBOOKGROUP LAUNCHEDNow it’s even easier to keep up to date with news, viewsand announcements from your favourite society! TheSociety has launched its brand new Facebook page to keepmembers informed of our activities. So, to find out thelatest news from the Society, what’s hot in the world ofendocrinology and join the online endocrine communityvisit us at www.facebook.com/SocietyforEndocrinology.Also, don’t forget to check out the Society’s Twitterchannel at www.twitter.com/Soc_Endo.SOCIETY FOR ENDOCRINOLOGYCAREERS WEBSITEThe Society for Endocrinology careers website is continuallyupdated with science, medicine and nursing vacancies,funding opportunities and prizes, as well as providing othercareers resources and links. If you fancy a change of careeror are looking for more funds for your research, come andhave a look at www.endocrinology.org/careers.If you have a vacancy or grant you want to advertisefree of charge please email us at careers@endocrinology.org.Upcoming Societypublic eventsThe Society is organising a number of public events in2011. The Doctor and The Master which will take placeat the Edinburgh International Science Festival, 9–22April 2011, will explore the role of the body’s ‘master’gland, the pituitary, in controlling many functionssuch as growth, fertility and metabolism. Tickets areavailable now at www.sciencefestival.co.uk.The Society will also visit the Cheltenham ScienceFestival, 7–12 June 2011. This year, we will be an officialfestival partner and will be sponsoring two events ontopics involving gender and obesity, in association withthe Society of Biology. Further details can be found athttp://cheltenhamfestivals.com/science/For more information on all Society public events,see www.endocrinology.org/public/.New public websiteThe Society is pleased to announce that we will belaunching our new website, You & Your Hormones, at theSociety BES conference in Birmingham, 11–14 April 2011.You & Your Hormones is a brand new resource for thepublic with the aim of providing accurate and reliableinformation on hormonesand hormone-relatedconditions.More information onthe project can be found at www.yourhormones.info orvisit our stand at the Society BES meeting to find outmore about this exciting new resource.2011 SocietyBES conferenceThere’s still time to register to attend the Society BESconference, taking place in Birmingham 11–14 April2011. The Society BES conference is the UK's premierscientific meeting on hormone research, where youcan find out about the latest cutting edgedevelopments in your field of research.This four day meeting will encompass the breadthof endocrinology from basic science and translationalresearch to clinical investigation and practice. There willbe oral communication sessions, along with a largeposter display and exhibition. We will be runningtailored sessions for nurses, the highly popular YoungEndocrinologists’ Symposium will provide advice onhaving a successful research career and, back by populardemand, our ‘Meet the Expert’ sessions return for bothclinicians and basic scientists.Conference highlights will include plenary lecturesfrom Professor Evan Simpson (Melbourne, Australia),Professor Peter Fuller (Melbourne, Australia), ProfessorJohn Kopchick (Athens, OH, USA), Professor Bruno Allolio(Wurzberg, Germany), Professor Xavier Bertagna (Paris,France), Professor Graham Williams (London, UK),Professor Samuel Refetoff (Chicago, USA), Professor JohnBevan (Aberdeen, UK) and Dr Jim Fagin (New York, USA).To find out more, to register, or to view the fullprogramme see www.endocrinology.org/meetings/2011/sfebes2011.The Tide Tables – New UK tourFollowing a successful pilot production supportedby the Wellcome Trust and the Society forEndocrinology at The Courtyard, Hereford, in May2009, Christine Watkins of Honeysuckle Directionhas won further backing to allow The Tide Tables toundertake a small UK tour.The play examines the conscious experiences ofmid-life for women and the biomedical science thatunderlies these experiences. Scientific input for theplay was provided by Professor Saffron Whitehead,St George’s University, London.Opening on Thursday 5 May at Aberystwyth ArtsCentre, the tour goes on to visit Brecon, Ludlow,Darlington, London, Jersey and Canterbury; full dates anddetails can be found at www.honeysuckledirection.org.6T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

AUTUMN ENDOCRINE RETREATWISH YOU WERE HERE?October 2010 saw another highly successful Autumn Endocrine Retreat in the environs of the picturesque Milton Hill Hall inOxfordshire. We thank the faculty members for their support, especially convenors Dr Ruth Andrew and Dr Derek Renshaw.What did the 20 delegates think of the event?Initially apprehensive about travelling alone to the stunningsetting of the Milton Hill House, I was struck by thefriendliness of the other delegates and the warm welcomefrom the faculty members. All the presentations given bythe faculty were light-hearted, reflecting the laid-backapproach to the whole retreat, but they also conveyedimportant messages about approaches to science and yourcareer. The delegates were divided into groups, each taskedwith critically reviewing a paper in an unfamiliar subjectarea. The main task of the weekend involved preparing agrant proposal based on the paper. Each group thenpresented their proposal to the faculty members, in themanner of Dragon’s Den, which added some competitivefun, but this will also prove to be an extremely usefulexperience for most delegates in the near future. Overall,the weekend was a big success and I now have a newbunch of friends to network with at conferences, as well aspossible collaborators for the future.LOUISE DIVER, UNIVERSITY OF GLASGOWBefore I go on any course or event, I always worry aboutthe following: the people will be strange, everyone willknow so much more than me, and because it’s free itmust be in an awful place!I can categorically state that all three of these statementswere not true in the case of the Autumn Endocrine Retreat.Highlights of the weekend were the plenary lectures givenby the faculty members, covering a range of important andrelevant topics. But it was not all work related - the eveningswere a great time to network and make friends. I wouldrecommend the retreat to anyone.MICHELLE SLEETH, IMPERIAL COLLEGE LONDONThe tasks we were assigned were challenging andintellectually stimulating; while the lectures ranged insubject matter from grant writing tips, to the pros andcons of doing a post-doc abroad - these were a greatopportunity for us to learn from the experiences ofeminent endocrine researchers.KYLIE BEALE, IMPERIAL COLLEGE LONDONThe retreat is a fantastic opportunity for youngermembers of the Society; by providing an informal setting,the barriers sometimes seen between trainee and seniorscientists are broken down. For me, the retreat allowedme to gain more confidence in my ability not only as ascientist but as a presenter. New friendships with peoplefrom different areas of research to my field of expertisewill, no doubt, continue to be a source of support andhelp me to become a better academic researcher.ROLAND STIMSON, UNIVERSITY OF EDINBURGHAs a PhD student, I found the retreat a fantasticopportunity - not only to meet my peers, but it alsooffered a friendly environment in which to meet principalinvestigators. I felt the retreat helped to shed light onhow to tackle life as a post-doc, and how to work withpeople from different backgrounds and at differentstages of their career.AMANDA PATIST, UNIVERSITY OF MANCHESTERThe faculty members’ personal accounts of theirexperiences in science at home and abroad exposed thecareer ‘do’s and don’ts’ for a young scientist. I foundthese really inspiring, and found the faculty members’energy and enthusiasm for science contagious.MITTAL SHAH, ROYAL VETERINARY COLLEGEThe team work elements of the retreat gave me insightinto group dynamics, awareness of how I function withina group, and my potential strengths and weaknesses as aleader - which are all valuable lessons for co-ordinating aresearch group in the future. The faculty membersremained good-humoured, positive, and encouragingabout an academic career in science throughout.FIONA WU, UNIVERSITY OF BRISTOLPlaces on the 2011 Autumn Endocrine Retreatpromise to fill quickly – register your interestearly at conferences@endocrinology.orgwww.endocrinology.org/meetings/aer/.8 T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

Regional Clinical Cases- from strength to strengthIn December the Society held its third RegionalClinical Cases meeting, this time in association withthe South East Region Endocrine Club, at theLansdowne Place Hotel in Brighton.Building on the success of the Regional Clinical Casesmeetings held in Birmingham and Edinburgh, Dr SimonAylwin (London) and Dr Anna Crown (Brighton)constructed an excellent whole day programme in whichthe 10 case presentations were interspersed with lecturesfrom Professor Colin Dayan,Dr Pauline Kane, Dr John Miell, Dr John Newell-Price anda debate involving Dr John Quinn and Dr Tom Scanlon.The meeting was a big hit with the 45 delegates whodefied the icy conditions, 92% of whom described themeeting as ‘excellent’ and complimented the programmeas ‘balanced and well designed’.Dr John Miell thought that it was ‘Great to see somany real juniors (medical students and foundation yeartrainees) performing at a standard that would havegraced any international meeting’. Dr Aylwin thoughtthat the meeting’s success had much to do with theformat including the right mix of lectures and cases: ‘Wewere delighted that so many eminent endocrinologistsfrom the wider region and beyond braved the snow andagreed to share their knowledge and experience’.Hearty congratulations are extended to the prizewinners: Ms Rachel Roberts received first prize for heroral presentation, with Dr Ben Whitelaw receiving secondprize; while the two poster prize winners were Dr TomasAgustsson and Dr Julianne Mogford.The details of the next few Regional Clinical Casesmeetings can be found atwww.endocrinology.org/meetings/.Clinical Update – new coordinator, same old successIn November the Society held the latest ClinicalUpdate Course (CU10). This was the first in a new cycle,which covers the national curriculum over three years,and the first coordinated by Professor Wiebke Arlt(Birmingham). Wiebke introduced some new facultymembers to teach and to deliver the workshops, butleft the proven format of a mixture of didactic lectures,seminars and case presentations unchanged.The eight convenors and 16 additional facultymembers ensured that the course had experts in everyfield, while the informal collegiate atmosphereencouraged the sharing of expertise, advice andknowledge. An analysis of the evaluation forms revealedthat the 194 delegates were attracted to the overallformat of the course, the topics covered in theworkshops and the positive experiences gained atprevious Clinical Updates. Here is a small sample of whatdelegates had to say:‘Best meeting for a trainee in endocrinology’‘Excellent teaching and interaction, information aboutmanagement not obtainable elsewhere’‘Good update for an established consultant’‘Strengthened my knowledge in areas of weakness andfurther consolidated my knowledge in areas of strength’‘Formal format, yet an informal and invitingatmosphere’CU11 will be held in Sheffield, 7–9 November 2011.You need not have attended CU10 in order to go to CU11.Register your interest now at conferences@endocrinology.orgwww.endocrinology.org/meetings/clinicalupdate/.7-9 November 2011 HILTON HOTEL, SHEFFIELD, UKThe Clinical Update programme provides essential training for all trainees and new consultants inendocrinology and diabetes, covering the PMETB national curriculum over a three year period. 2011 is the2nd year of this cycle, although attendance at CU10 is not a prerequisite.The three day programme comprises didactic lectures and small interactive workshops based around thepresentation of routine cases by delegates. This mixed format ensures the generation of an excellent collegiateatmosphere that promotes an effective forum for networking with peers and more established endocrinologists.This highly successful, premier clinical training course has been over-subscribed in the past and registrationwill be on a first-come, first-served basis, so register your interest at conferences@endocrinology.org tobe notified by email when registration will go live.T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 19

ENDOCRINOLOGY AND DIABETES IN THE UNDERGRADUATECURRICULUM: WHY CHOOSE OUR SPECIALTY?Many of us go into clinical endocrinology becauseof role models who may have inspired or encouragedus at an early stage in our career. It might simply havebeen pure academic intrigue ignited by a dynamiclecture or seminar at medical school. Therefore, inorder to attract and recruit the best people into ourspecialty, we need to ensure that inspirational clinicaland academic endocrinologists are given sufficientairtime to students at medical schools across the UK.With this in mind, John Wass asked me to conduct asurvey on behalf of the Clinical Committee to look atthe undergraduate medical school curriculum in the UK.By happy coincidence, Tony Weetman, Professor ofEndocrinology at Sheffield, is Chair of the MedicalSchools Council: he strongly advised sending the surveydirectly to our clinical colleagues rather than goingthrough medical school red tape.I duly sent a series of questions to senior clinicalendocrinologists at all 31 medical schools in the UK. Theresponses were interesting and a few consistent themesemanated from the survey. Most people felt that it wasimportant to involve senior clinicians at an early stage inboth the design and delivery of the undergraduatecurriculum; a lecture on Cushing’s syndrome orhyperthyroidism is far better received if it is given by aclinician who routinely manages these conditions, thanby someone who has never seen a real case.Examples of particularly innovative practices includelive multi-disciplinary team (MDT) discussions, such asthe one at Addenbrooke’s Hospital, Cambridge, whichare filmed and given with a preceding refresher lectureon the relevant endocrine disorder. On the other handThe University of Aberdeen Medical School, is developingan electronic endocrinology clinical cases forum. Sadly,many of the responses indicated that not all studentshave compulsory exposure to endocrinology anddiabetes at their medical school, which may bedetrimental to recruitment into our specialty.Encouragingly there are opportunities for students toperform BScs in endocrinology in departments withresearch activity, and all respondents were very happywith the concept of cross-pollinating students from othermedical schools.Other suggestions taken from the survey include:the development of core standards for a nationalundergraduate curriculum; ensuring questions onendocrinology appear in all finals examinations; theencouragement of innovative teaching methods,particularly those which embrace interactive technology.It was agreed that the best way forward was to set up aformal meeting, either face-to-face or via teleconference,between education leaders and other interested parties,to discuss the issues raised in the survey. Abhi Vora isbringing this all together and progress will be reportedto the Clinical Committee, with more information to bedisseminated via the Society website, and at futureDiabetes UK and Society BES meetings.MILES LEVYISSN 0300-0664 / 1365-2265 (online)CLINICALENDOCRINOLOGYTHE CLINICAL JOURNAL OF THE SOCIETY FOR ENDOCRINOLOGYVOLUME 73 • NUMBER 5 • NOVEMBER 2010Edited by: J S Bevan, W F Young and S J Juddwww.clinendo.comwww.blackwellpublishing.com/cenJ. S. Bevan | W. F. Young | S. J. JuddSenior Editors:Clinical Practice Update: Cerebral cavernoma after radiotherapy in childhoodClinical Question: What is the best approach to an apparentlynon-metastatic adrenocortical carcinoma?Why choose Clinical Endocrinology to submit your paper?Editor’s Choice: Evaluation of pituitary function aftertraumatic brain injury in childhood• Submission to first decision in an average of just 14 days• Accepted Articles function – have your peer-reviewed,accepted article published online as soon as it’s ready,prior to inclusion in an issue and before copy-editing• Quick and easy online submission process throughScholarOne Manuscripts• 2009 impact factor: 3.201 with over 10,000 total citations in 2009• High international readership with nearly 600,000 abstracts downloaded in 2009Submit your paper todayhttp://mc.manuscriptcentral.com/cen10 T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

Granting independenceIn these straitened times, the Society is glad to be able to continue a full programme of grants and awards. Early careergrants are intended to directly support endocrinologists, possibly through providing the resources to gain preliminarydata before applying for other external funding, money for a specific piece of equipment, the resources to finalise aproject or short term salary funding. A full review of these activities is published in the autumn issue of TheEndocrinologist each year; this report escaped to whet your appetite.Glucocorticoids act via the intracellularglucocorticoid receptor to regulate cellular growth,metabolism, survival and the response toinflammatory stimuli.Dividing cells have a reduced sensitivity toglucocorticoids, and so tissues with an increased mitoticindex have impaired glucocorticoid sensitivity. This isaccompanied by changes in glucocorticoid receptorfunction, which remain poorly defined. With supportfrom the Society Early Career Grant, I have defined thelocalisation and activity of the glucocorticoid receptorduring mitosis, and found an entirely new mode ofglucocorticoid receptor action, as a regulator ofchromosome segregation. This is a major newdiscovery, and one with implications not only inunderstanding glucocorticoid receptor biology but alsofor the field of steroid hormone action.Work conducted over this past year has contributedto the completion of a significant body of work thatnow forms two manuscripts currently under review.This funding has also enabled the establishment ofcollaborative links between Tony Michael and RachelWebb (St George's University of London), and myself atthe University of Manchester. The preliminary dataobtained so far is very exciting and will form the basisof an application for more substantive grant fundingfrom other UK funding bodies.Since receiving this grant, I have been awarded a4-year University of Manchester ‘FMHS Stepping StonesFellowship’ to continue my research. I have alsosuccessfully obtained funding for two PhD studentships:an integrative systems biology (MCISB) studentship anda BBSRC CASE studentship in collaboration withGlaxoSmithKline. I have submitted an application tofund a 5-year programme of collaborative research,and intend to apply for an externally funded personalfellowship in September 2011.Support from the Society Early Career Grantsprogramme has been instrumental in my progress overthe past year. I now feel well placed to successfullycompete for external fellowships, and establish myselfas an independent researcher in the field ofglucocorticoid receptor biology.LAURA MATTHEWS, MANCHESTER UNIVERSITYThe next deadline for applications forthe Early Career Grant is 27 May 2011,see www.endocrinology.org/grants/for further details.5th Hammersmith Endocrine SymposiumThe Society for Endocrinology sponsored the 5thHammersmith Multidisciplinary Endocrine Symposiumon 10 December 2010 at Hammersmith Hospital,London. This annual meeting brings together traineesand consultants from all specialties who managecomplex endocrine patients in multidisciplinaryteams, so that they can share best practice anddiscuss difficult cases. The 190 delegates also included30 MEN-1 and MEN-2 patients, who attended themain meeting and the parallel sessions specificallydesigned for them. This year’s meeting had a strongadrenal theme.The audience were updated on the diagnosis ofphaeochromocytomas by Professor Morris Brown(University of Cambridge) and learnt about localisationfrom Dr Bomanji (University College Hospital, London)and Dr James Jackson (Hammersmith Hospital). ProfessorJohn Wass (Churchill Hospital, University of Oxford)discussed the pre-operative preparation ofphaeochromocytomas. There was lively interaction anddebate from the audience during the Conn’spresentations, both presentations used rovingmicrophones and interactive clickers so that the audiencecould vote for particular options. This was followed by aSociety for Endocrinology sponsored seminar byProfessor Martin Walz (Essen,Germany) who gave a trulyunique surgical experience of1131 retroperitoneoscopicadrenalectomies.Adrenalectomies can nowbe performed through alaparascopic keyholeprocedure from the back!Later in the day focusturned to debating the role of surgery: Mr David Scott-Coombes (Univeristy Hospital of Wales, Cardiff) versusradioiodine treatment Professor Karim Meeran(Hammersmith Hospital) in Graves’ disease.Congratulations to Mr Scott-Coombes who had a smallershare of the vote from the audience but gained a greaterswing over Professor Meeran at the end of the debate.The Society supported two £100 prizes for the bestposters which were awarded to Dr N Sznerch (UniversityHospital Wales, Cardiff) and Dr A Theodoraki (Royal FreeHospital, London). You can enjoy all the abstracts onlineat http://metmed.info. Preparations are underway for the6th Hammersmith Endocrine Symposium, which will takeplace on 9 December 2011, for further details seehttp://metmed.info/.Professor MartinWalz deliveringthe Society forEndocrinologysponsoredseminar onretroperitoneoscopicadrenalectomyT H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 111

Nurses’ NewsOn behalf of the Nurse Committee I would like towish you all a Happy and Healthy New Year. I cannotbelieve that it is a year since I took over as Chair of theNurse Committee. A lot of positive things havehappened in that year, so I thought I would take thisopportunity to share with you what the committee hasbeen doing, and is planning to do in the future.Following elections in November we are pleased towelcome two new committee members - Ann Marlandfrom Oxford and Morag Middleton from Aberdeen. Iwould like to thank Jean Munday, who recently retiredfrom the committee, for her commitment and hardwork. I am pleased to say that Jean will still be involved,as she has agreed to join the sub-committee developingcore endocrine nursing competencies.We continue to work towards developing corecompetencies for adult endocrine nurses; to carry thisout we have set up a working group comprised of amixture of interested Nurse Members and committeemembers. We held our first sub-committee meeting inFebruary, and will report on progress in a future issue: ifany Nurse Member has an idea they would like to putforward, or would like to help in the development ofthese competencies please do get in touch with AnnLloyd (ann.lloyd@endocrinology.org).The nurses’ sessions at the Society BES 2011,13 April, are now finalised: the topics will be Turner andKlinefelter’s syndrome in the morning session, andthyrotoxicosis in the afternoon. We are now busyplanning the sessions for the Society BES 2012 and willbe calling for volunteers to take part soon.Following on from the successful re-launch of theEndocrine Nurse Update, the committee is busypreparing for this year’s update. The recent call for casestudies and speakers enjoyed an excellent response -thank you to those of you who have replied, we will bein touch soon. We plan to return to Stratford-upon-Avonon 19–20 September 2011 as the venue proved verypopular with delegates last time. Please put the dates inyour diaries!The Certificate of Adult Endocrine Nursing is soon tobe re-launched - we have been working hard to make thisan even more robust educational achievement. There arefour compulsory elements: attendance at Endocrine NurseUpdates; submission of a portfolio of evidence;attendance at the Society BES meeting, or Clinical Updatemeetings; and evidence of abstracts accepted for scientificmeetings, on which the candidate is first author. Thecommittee felt that a portfolio of evidence would moreclearly demonstrate personal development than theprevious Certificate requirement for an essay. If you areinterested in undertaking the certificate please contactAnn Lloyd (ann.lloyd@endocrinology.org). The committeehas put together a starter pack for guidance which is nowavailable on the website, along with more detailswww.endocrinology.org/endocrinenurse/training.html.For the first time, nurses were involved in the recentInterdepartmental Peer Review in Cardiff. In Novembertwo committee members, Chris Gibson (Manchester)and Lisa Shepherd (Birmingham), spent 2 days in Cardiffas members of the review team. Their input proved to bevery useful and nurses are to be included in this processfrom now on.We have been looking at other ways to supportendocrine nurses and have developed an online resourcewhich will soon be appearing on the website(www.endocrinology.org/endocrinenurse/). This includes‘how to’ sections on: endocrine tests, writing an abstract,doing a case study, and chairing a meeting. There isadvice on how to become a committee member andsome examples of career pathways. It also lists patientgroup contact details and links to useful new research inendocrinology. It is hoped that this will be a valuableresource especially for nurses new to endocrinology.Finally I would like to say to Nurse Members that weare your voice in the Society. We can only continue topromote endocrine nursing with your support. TheEndocrinologist is published four times a year and we arealways looking for copy. Articles, no matter how big orhow small, are welcomed. Topics could cover somethingyou have developed, a study you have been involved in,a case study on the nursing care of an endocrine patient:anything you think might be of interest. Otherwise youwill have to put up with my ramblings instead, and I amsure you must by now be fed up with hearing my voice.If only to prevent this happening get your laptops outand get writing ready for the next issue!NIKKI KIEFFERDeadline for news items for the Summer 2011 issue: 1 April 2011.Deadline for news items for the Autumn 2011 issue: 5 August 2011.How do I join the Society?The Society welcomes anyone working in an endocrine-related field anywhere in the world and at any stagein their career. If you would like to take advantage of the many benefits of membership, for example,access to a comprehensive list of grants, free online access to the Society’s journals, reduced registration feesat Society-organised conferences, clinical days and training courses, just complete the application form atwww.endocrinology.org/membership or contact the Society by emailing members@endocrinology.org.12 T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

Catherine WilsonCatherine Wilson, who died at the age of 74, willbe remembered by her many friends and colleaguesnot only for her notable research career but also forher generous spirit and zest for life.Cathy trained in Pharmacy at Chelsea College,London, and after graduating spent a few years workingin the pharmaceutical industry. In 1969 she returned toChelsea College as a research fellow in the PharmacologyDepartment and was appointed Temporary Lecturer inPharmacology in 1971. From 1972–1974, she worked asResearch Fellow to P G McDonald at the Royal VeterinaryCollege, earning, in 1974, a lectureship in Pharmacology.In 1979 Cathy was appointed Senior Lecturer inReproductive Physiology in the Department of Obstetrics& Gynaecology at St George’s Hospital. It was here thather research on the hypothalamic control of gonadalfunction really took off and in 1986 she was promoted toReader in Reproductive Physiology. At St George’s sheplayed a major role in linking clinical and basic research.In 1992 she was awarded a personal chair and in thesame year received a DSc from the University of London.In addition to her work at St George’s, Cathy was anactive member of numerous scientific societies includingthe Society for Endocrinology, British PharmacologicalSociety, British Neuroendocrine Group and the Societyfor Reproduction and Fertility. She was also a foundermember of the Society for Drug Research.Many postgraduate students benefited from Cathy’sguidance and friendship, while her research attractedworkers from around the world. She was so enthusiasticabout research and was most happy in the laboratory,considering it a way of life. Even after retiring shecontinued to work; thinking that freedom from academicduties would allow her more time for research. When Ispoke with her, just a few weeks before she died, she wasexcited about some new experiments and could not waitto get back into the laboratory.Cathy was not just an academic; she had manyother interests and commitments. She actively promotedthe arts and was a talented artist herself. Cathy will befondly remembered by her colleagues and the manyfriends she made throughout her life: she was aninspiration to us all.TONY THODYOBITUARIESAlan Michael WallaceMike Wallace died suddenly in New York onhis way home from the American Associationof Clinical Chemistry annual meeting. He wasjust 60 years of age. Prior to his prematuredeath Mike had been Consultant ClinicalScientist in the Department of ClinicalBiochemistry at Glasgow Royal Infirmary, NHSGreater Glasgow and Clyde. Mike was also an honoraryProfessor at the University of Strathclyde.Mike was born and raised in Dundee. He studiedbiochemistry at St Andrews University, where he met hiswife Pat. He moved to the University of Glasgow,Department of Steroid Biochemistry in 1972 tocommence a PhD on androgens. Thus began his lifelonginterest in biochemical endocrinology.After two years in London to complete his training asa clinical biochemist, Mike returned to his formerdepartment in Glasgow as an NHS clinical biochemist,rising through the grades and gaining FRCPath beforeachieving Consultant status in 2000.Mike was an excellent research scientist - he developedan interest in paediatric steroid biochemistry and introducednovel assays, including the first neonatal screeningprogramme for congenital adrenal hyperplasia. Later Mikebecame involved in polycystic ovarian disease and took theshort step to involvement in the biochemical endocrinologyof adipose tissue and clinical obesity. Another new areafollowed – this time in pioneering the assessment of ovarianreserve using anti-mullerian hormone. Most recently Mikeintroduced liquid chromatography tandem massspectrometry into the laboratory and developed the firstautomated mass spectrometric assay for 25-hydroxyvitaminD. This last project led to him becoming Scottish HealthcareScientist of the Year in 2008.Throughout his research career Mike understood thevalue of working in partnership with clinical colleagues andhe developed collaborative clinical research partners acrossthe UK, in Europe and in the United States. He also workedclosely with key diagnostic companies. As a result Mike wasan invited speaker at several international conferences.Mike’s expertise and reputation in endocrinology wererecognised when he was elected to serve as the only clinicalbiochemist on the Society for Endocrinology Council. Mikealso found time to work for the Association for ClinicalBiochemistry, serving with distinction for many years.But above all Mike was a great person – his middlename should have been ‘fun’. He had a constant twinklein his eye which told you that the next quip, tease or storywas imminent. He always remained positive; the glass wasalways overflowing and tomorrow would be even betterthan today. Mike was an enthusiastic and talented teacher,especially in small groups and a generation of clinicalbiochemists have appreciated his encouragement andsupport. Evidence of Mike’s popularity and respect wasshown by the ‘standing room only’ service in celebrationof his life - clinical biochemistry has lost a great scientistand many have lost a great friend.GRAHAM H BEASTALLT H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 113

Libel liable for reformWhilst a thick skin or a good sense of humour has long been essential for survival in academia, libel actionsare becoming increasingly commonplace in science. How is this affecting the scientific community?Modern communication has outgrown UK libellaws. As an increasingly inquisitive public wants toknow about cutting-edge science and medicine, sopublic funding schemes have adapted to meet andengage with this curiosity. Laudable though this is,does the exposure come at a price? Whilst aburgeoning science communication field is helping toaccurately portray current scientific thinking to thepublic, the scientific method is facing a very realthreat through legal actions facilitated by the UK’soutdated libel system.In an article published by the Daily Mail in October2010, Dr Dalia Nield, a respected cosmetic surgeon atThe London Clinic, expressed concerns over thesupporting evidence and proposed mode of action of‘Boob Job’ cream, a topical application advertised asbeing able to increase bust size. Rodial, themanufacturers of ‘Boob Job’ claim that her words weredefamatory and have threatened her with legal actionunless the comment is withdrawn.The situation Dr Peter Wilmshurst finds himself in ismore ominous. Dr Wilmshurst, a cardiologist at RoyalShrewsbury Hospital, UK, is currently defending two libelactions from Boston-basedREAL SCIENTIFIC ADVANCEMENT, medical device companyNMT Medical. The firstAND THE REALISATION OF ITS action is being taken overFULL ECONOMIC BENEFITS, comments regarding theresearch conduct of a trial heREQUIRES CRITICAL APPRAISAL. was participating in, madeduring a cardiologyconference and subsequent interview with a journalistfrom heartwire, an online news website based in theUSA. The second action concerns comments he made indefiance of the first libel action to BBC Radio Four’s TheToday Programme.These two cases highlight a very serious threat to freespeech and academic debate, as freely offering aprofessional opinion in the public interest is increasinglylanding more and more academics with a choicebetween a retraction or a hefty legal bill. Dr Wilmshurst’scase is notable because he is fighting it: the commitmentin time and money that a libel defence requires makesthe threat of libel action enough to silence manyacademics. A recent ruling ordered NMT Medical to pay£200 000 to the High Court in case Dr Wilmshurst won,as he could no longer afford to defend his case and makepayments on his house.Under UK libel law, even claimants based outside theUK enjoy the luxury of choosing their target, who thensuffers the burden of proof; while newspapers are wellplaced to protect themselves against such suits,individuals are not. UK libel laws can also be used to forceequally vulnerable scientific journals to retract a paper, asthe philosopher AC Grayling warns in the BMJ ‘even if theBMJ is confident it could win if sued, the huge expense ofdefending an action makes winning scarcely worthwhile… this is well known to those who sue’.A recent survey of publishers carried out by the LibelReform Campaign showed that 32% of medical andscientific editors say their journal has been threatenedwith libel action, 44% of editors have asked for changesto the way papers or articles are written to protectthemselves from a libel action, and a third of publishershave refused work from authors for fear of libel action.These findings led Justice Minister Lord McNally todescribe UK defamation laws as ‘not fit for purpose’.A great deal of increasingly scarce funding is likely tobe wasted if the stifling of debate continues. Realscientific advancement, and the realisation of its fulleconomic benefits, requires critical appraisal.Furthermore, if the capacity of academics to scrutiniseand question continues to be hampered by the threat oflibel, the impact on health, medicine and society at largecould be devastating.Whilst lawmakers must do what they can to makelibel laws fair, academics should reconcile themselves withnew legal realities. In the draft Defamation Bill making itsway through the House of Lords, the defences of publicinterest, honest opinion (currently referred to as ‘faircomment’) and truth stand. Whilst truth is a qualitydenied to all but the most established scientific facts,statements about the available evidence can always betrue, and the defence of public interest and honestopinion seem adequate to protect responsible critics. Thescience writer Simon Singh spent two years and over£200 000 fighting the British Chiropractic Association toclaim the fair comment defence for well-founded publiccriticism, and it is largely thanks to him that we areseeing reform. Let us not make his efforts in vain.TOBY STEADThe Society for Endocrinology supports the Libel ReformCampaign, which is a coalition between Sense AboutScience, Index on Censorship and English PEN. You can findout more about UK libel laws and sign their petition forreform at www.libelreform.org.14 T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

ALMIRALL LTDAlmirall is an internationalpharmaceutical company based on innovation and committedto health, headquartered in Barcelona, Spain. At Almirall weresearch, develop, produce and market novel medicines withthe aim of improving people's health and wellbeing. Wedevote significant human and economic resources toconstantly research into new drugs and to obtaining effectiveand safe products to treat discomfort and disease.Our research resources are focused on the treatment ofasthma, chronic obstructive pulmonary disease, rheumatoidarthritis, multiple sclerosis, psoriasis and dermatologicalconditions. Within dermatology an area of particular interestis the treatment of facial hirsutism, a distressing condition forsufferers that is often related to underlying endocrinedisorders in women.Our medicines are present in over 70 countries, with adirect presence in Europe and Latin America. Our objective isto help thousands of people around the world stay healthy.Almirall Ltd, 4 The Square, Stockley Park, Uxbridge,Middlesex UB11 1ET, UK (Tel: 0207-160-2500; Web:www.almirall.com)BAYER HEALTHCAREBayer HealthCare is one of theworld’s leading, innovative companies in the healthcare andmedical products industry. The company combines theglobal activities of the Animal Health, Consumer Care,Medical Care and Pharmaceuticals divisions. BayerHealthCare’s aim is to discover and manufacture productsthat will improve human and animal health worldwide.Bayer Healthcare has a global workforce of 53,400employees and is represented in more than 100 countries.The pharmaceutical division of Bayer HealthCare focusesits research and business activities on the following areas:Diagnostic Imaging, General Medicine, Haematology &Neurology, Oncology and Women’s Healthcare. Usinginnovative ideas, Bayer aims to make a contribution tomedical progress and strives to improve the quality ofpatients’ lives.Our Men’s Health portfolio features products fortestosterone therapy and erectile dysfunction.Bayer Plc, Strawberry Hill, Newbury RG14 1JA, UK (Tel: 01635-563000; Web: www.bayer.co.uk)BIOSCIENTIFICA LTDBioScientifica provides a range ofservices of specific relevance to medical and scientificsocieties, and the pharmaceutical industry. We can manageall aspects of your conference, including abstractmanagement, and handle your secretariat and membershipservices. An experienced publisher of books, journals,newsletters and conference proceedings, we can also createand maintain websites on your behalf. If you are looking forany of these services, get in touch!BioScientifica manages conference services for theSociety for Endocrinology, European Society ofEndocrinology, British Fertility Society, Cancer and BoneSociety, British Oncological Society, United Kingdom andIreland Neuroendocrine Tumour Society, and Ipsen andNovartis Pharmaceuticals. We provide a full online abstractpublishing service for several clients.We act as the standing office for five learned societies,offering full membership services, enquiry handling,committee meeting management, production of newslettersand advice regarding governance and other proceduralmatters. BioScientifica handles the external relations for theSociety for Endocrinology, European Society ofEndocrinology and the British Fertility Society. The followingpublications are managed by BioScientifica:Journal of Endocrinology, Journal of Molecular Endocrinologyand Endocrine Related Cancer, published in print andonline with HighWire Press for the Society forEndocrinologyEuropean Journal of Endocrinology, published in print andonline with HighWire Press for the European Society ofEndocrinologyReproduction, published in print and online with HighWirePress for the Society for Reproduction and Fertilitya range of books, including: the KIMS annual overview;Acromegaly: a handbook of history, current therapy andfuture prospects, Handbook of Cancer-Related BoneDisease, Handbook of Gastroenteropancreatic and ThoracicNueroendocrine Tumours and Handbook of Cushing’sDisease.Our in-house website management service has createdand maintains more than ten websites for societies and otherorganisations.BioScientifica Ltd, Euro House, 22 Apex Court, Woodlands,Bradley Stoke, Bristol BS32 4JT, UK (Tel: 01454-642240;Web: www.bioscientifica.com)ELI LILLY AND COMPANYEli Lilly and Company is one of theworld's largest research-based pharmaceutical companies,dedicated to creating and delivering innovativepharmaceutical healthcare solutions that enable people tolive longer, healthier and more active lives. Our research anddevelopment efforts constantly strive to address urgentunmet medical needs. Eli Lilly and Company was founded in1876 in Indianapolis, USA, and has had a long history ofproducing endocrine products, dating all the way back tothe collaboration with Banting and Best and the introductionof the world's first insulin product in 1922.Another element of Lilly's endocrine portfolio is GHreplacement. Lilly manufactures recombinant human GH(somatropin) at Speke near Liverpool, UK. A full range ofproducts and services is provided for the healthcareprofessional to use with their patients on GH replacementtherapy for both adults and children. To assist in thetherapeutic management of osteoporosis, Lilly has twoproducts, each catering for different patient needs:Raloxifene and Teriparatide.Finally, Lilly continues to focus significant resources onresearch into the endocrine area. For additional informationabout any of our endocrine products or services please logon to the Lilly website: www.lilly.co.uk.Eli Lilly and Company Ltd, Lilly House, Priestley Road,Basingstoke RG24 9NL, UK (Tel: 01256-315000;Web: www.lilly.co.uk)Corporate Supporters’ ProfilesT H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 115

Corporate Supporters’ ProfilesFERRING PHARMACEUTICALS LTDFerring Pharmaceuticals is amultinational company with corporate headquarters in Saint-Prex Switzerland; the organisation’s marketing, medicalservices and sales teams operate in more than 45 countriesand employ over 3700 people throughout the world.Ferring’s portfolio demonstrates an exceptionallyinnovative and successful track record in endocrinology,reproductive health – infertility and obstetrics, urology,gastroenterology and oncology. Ferring is a world leader inthe research and development of peptides and hormonetherapies, focusing on producing treatments that enabledoctors to treat patients on the body’s own terms.Ferring Pharmaceuticals Ltd, The Courtyard, Waterside Drive,Langley SL3 6EZ, UK (Tel: 01753-214800; Web: www.ferring.co.uk)IPSEN LTDIpsen is an innovation-driven globalspecialty pharmaceutical group with over 20 products and atotal worldwide staff of nearly 4200. Its developmentstrategy is based on a combination of specialty medicine,which is Ipsen's growth driver, in targeted therapeutic areas(endocrinology, oncology, neurology and haematology), andprimary care products which contribute significantly to itsresearch financing.We have been pleased to support the field ofendocrinology since 1998, and Ipsen’s expanding portfolioincludes a range of products with sophisticated sustainedrelease delivery systems for the management of varioushormone-related diseases. The location of its four researchand development centres (Paris, Boston, Barcelona, London)and its peptide- and protein-engineering platform give thegroup a competitive edge in gaining access to leadinguniversity research teams and highly qualified personnel.More than 800 people in research and development arededicated to the discovery and development of innovativedrugs for patient care. For more information on Ipsen, visitour website at www.ipsen.com.Ipsen Ltd, 190 Bath Road, Slough SL1 3XE, UK(Tel: 01753-627700; Fax: 01753-627701; Web: www.ipsen.com)MERCK SERONO LTDAt Merck Serono, we are activelycommitted to bringing therapeutic innovations to patients.We specialise in the treatment of cancer, neurodegenerativediseases, infertility, endocrine and metabolic disorders,cardiovascular diseases and other conditions with unmetmedical needs.We are internationally recognised as a biotechnologyleader, with innovative and successful products along with awell-stocked and promising development pipeline.Specialised know-how in research and production meansthat we are able to ensure very high-quality manufacturing,a key success factor especially in the biopharmaceuticalindustry.Merck Serono is committed to improving the lives ofpeople with a range of endocrine and metabolic disordersincluding growth hormone deficiency and diabetes. MerckSerono was a pioneer in making recombinant human growthhormone available for the treatment of growth hormonedeficiency in children and adults. Merck Serono continues tobring benefits to patients through its treatments and familyof easy-to-use drug delivery devices, we continue to pursuefocused development in endocrinology.Merck Serono Pharmaceuticals Ltd, Bedfont Cross,Stanwell Road, Feltham TW14 8NX, UK (Tel: 01371-875876;Web: www.merckserono.co.uk)NOVARTIS PHARMACEUTICALS UK LTDOur mission at Novartis is to discover,develop and successfully market innovative products toprevent diseases, to ease suffering and to enhance thequality of life. As one of the largest pharmaceuticalbusinesses in the world, Novartis has a responsibility toprotect and invest for the future. In 2009 Novartis invested$7.5 billion USD in research and development.Novartis Oncology has a strong heritage in cancer care.Indeed, over the past 25 years pioneering research hasrepeatedly resulted in new and innovative products, such asour cutting edge, rationally designed, molecularly targetedcompounds.Novartis Pharmaceuticals UK Ltd, Frimley Business Park,Frimley, Camberley GU16 7SR, UK (Tel: 01276-692255;Fax: 01276-698605; Web: www.novartis.com)NOVO NORDISK LTDNovo Nordisk was founded in 1923out of a passion to help people with diabetes. With ourstrong commitment to patients and by offering the largestportfolio of products in the industry, we look to defeatdiabetes by improving: awareness, prevention, detection,and treatment of this chronic disease. In addition, NovoNordisk holds a leading position within the areas ofhaemostasis management, growth hormone therapy andhormone replacement therapy.We also believe that it is important to change the futureof diabetes and, together with others, we have introduced anumber of initiatives to achieve this. In recognition of thefact that diabetes is a global epidemic, the World DiabetesFoundation (WDF) was established in 2002 to support theprevention and treatment of diabetes in the developingworld. In 2008 Novo Nordisk launched a five year ‘ChangingDiabetes in Children’ programme to reduce child mortalityand save 10 000 children in sub-Saharan Africa by 2015.Within the UK, providing financial assistance to support theOxford Centre for Diabetes, Endocrinology and Metabolismhas gone some way to achieve the Oxford Vision 2020.Novo Nordisk remains committed to improving the livesof patients with diabetes.Novo Nordisk Ltd, Broadfield Park, Brighton Road, CrawleyRH11 9RT, UK (Tel: 01293-762000; Web: www.novonordisk.com)16 T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

PFIZER LTDThe Speciality Business Unit of PfizerLtd has a long established portfolio of endocrine products(medicines and devices), with a broad range of indications,and innovative services, as well as a history of servingpatients’ and physicians’ needs for more than twenty years.Pfizer is committed to improving understanding ofendocrine disorders such as adult growth hormonedeficiency and acromegaly through the KIMS andACROSTUDY databases, which now have more than 30 000and 800 patients, respectively, enrolled worldwide. Thepartnership with endocrine health professionals in datacollection has shown to be important in monitoring thesafety and efficacy of the treatments. More recently KIGS &KIMS has been valuable in informing health technologyassessors on the cost-effectiveness of growth hormonetreatment. In 2010 Pfizer launched a web-based version ofKIMS which will aim to make the use of the database moreuser friendly. Further application of the data collected isbeing investigated by Pfizer, with the aim of helpingindividual centres access valuable information to help in theeffective management of patients on growth hormonetreatment.Pfizer have recently embarked on an initiative to helpendocrine healthcare professionals improve their skills innon-clinical areas through a professional and personaldevelopment programme. This is delivered throughstructured courses and internet web-based learning. Theprogramme is called E3 – Enhancing Excellence inEndocrinology.Pfizer Ltd, Walton Oaks, Dorking Road, Tadworth KT20 7NS,UK (Tel: 01304-616161; Web: www.pfizer.co.uk)SANDOZ LTDSandoz, a division of the Novartisgroup, is a world leader in high quality generics andbiopharmaceutical medicinal products. Sandoz develops andmarkets a wide variety of active ingredients and finishedproducts, having a portfolio of more than 840 compounds inover 5000 forms. Novartis is the only major pharmaceuticalcompany to have leadership positions in both patentedprescription drugs and generic pharmaceuticals.In 2005, Hexal AG (Germany) and EonLabs Inc (USA)became part of Sandoz. In 2006, the business employedabout 21 000 people worldwide. It sold its products in morethan 110 countries and posted sales of $6 billion USD.Sandoz's recombinant human growth hormone Omnitropereceived marketing authorisation from the EuropeanCommission in April 2006 and has been launchedsubsequently in several European countries. In the USA,Omnitrope was launched in January 2007. In Australia,Omnitrope has been on the market since November 2005.Biosimilar medicines made by Sandoz: fully adhere to thenew and rigorous European standards for biosimilar medicinalproducts; guarantee a high quality production process, asSandoz ranks among the world's largest and mostexperienced manufacturers of biotechnological products;ensure patient care and safety through appropriate preclinicaldevelopment, clinical trials and postmarketing surveillance,including a state of the art pharmacovigilance system; helpreduce the burden on healthcare systems by providing thepublic with safe and effective medicines at competitive prices.Sandoz International GmbH, Industriestrasse 25, 83607Holzkirchen, Germany (Tel: +49-8024-4762591;Fax: +49-8024-4762599; Web: www.sandoz.com)Corporate Supporters’ ProfilesNew Funding forClinical Endocrine Auditavailable from the Clinical Endocrinology TrustThe Clinical Endocrinology Trust (a charity which derives its income from a profit-share of theSociety’s official clinical journal, Clinical Endocrinology) has long supported Endocrine Audit projectswithin the UK. Recent examples include the UK Acromegaly Database and the CaHASE audit of adultswith CAH. The CET has recently awarded funding to the BTA to evaluate the iodine status of teenagegirls across the UK.The Trustees now invite further Clinical Endocrine Audit applications from Societies or EndocrineCentres. Preference will be given to projects involving multicentre collaborations. We are particularlyinterested in receiving applications related to areas of endocrinology the Trust has not supportedpreviously. A sum of £40 000 is available during 2010–2011 for one or more projects judged by theTrustees to be worthy of support: their decision will be final.Applications should be limited to three A4 sides and structured as follows:Background, Aims, Methods, Funding Justification and References.Closing date for applications is 30 June 2011 and should be sent toProfessor Julian Davis (CET Secretary) at julian.davis@manchester.ac.ukThe CET looks forward to hearing from you!The Clinical Endocrinology Trust (Registered Charity 288679)Trustees: Prof A P Weetman Chairman, Prof J R E Davis Secretary & Treasurer, Prof J M Connell, Prof J A Franklyn, Mrs E WhelanSociety for Endocrinology Secretary & CET Observer: Prof P M StewartT H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 117

all aboard for... SheffieldPassengers on the Endo Train will arrive in Sheffield on the Master Cutler, the expresstrain from London, named after the head of the Company of Cutlers, one of the fewguilds outside London. Sheffield, like Rome, was built on seven hills – these generate therivers that powered the water wheels that turned the grindstones that sharpened thesteel that made Sheffield famous. Richard Ross takes us for a tour.Locomotive 45407The Master CutlerIn the 18th century Sheffieldproduced a third of the world’sspecialised steel and the hallmark,‘Made in Sheffield’, was foundon cutlery the world over. Thebackbone of Sheffield’scutlery and tool makingindustry were thecraftspeople, knownas the Little Mesters,who enjoyed areputation as highlyskilled and specialisedworkers. It is in thistradition of small groups creating a criticalmass that the current Department of HumanMetabolism in Sheffield has developed to include thetop UK centre for bone research, and one of thelargest UK groupings of adult and paediatricendocrinologists.Sheffield has a rich academic heritage ofendocrinologists on which to build. In 1920, Sir EdwardMellanby opened the way for the discovery of Vitamin Dby demonstrating that cod liver oil was curative of ricketsin dogs. Mellanby recruited Howard Florey to Sheffield,who went on to jointly receive the Nobel Prize for thediscovery of penicillin. Mellanby was also influential inappointing Hans Adolf Krebs to Sheffield, who, in 1953,received the Nobel Prize for describing the carboxylicacid cycle. It is in Mellanby’s honour that the recentlyopened Centre for Bone Research was named. At thesame time, Professor (later Sir) Edward Wayne andcolleagues undertook a number of pioneering studies inthyroid disease and in 1951 reported the first use in theUK of radioiodine treatment for hyperthyroidism.The modern era of bone research in Sheffield beganwith the establishment of the Department of ChemicalPathology in 1974 by Professor Jack Martin andcontinued by Professor Graham Russell in theDepartment of Human Metabolism and ClinicalBiochemistry. Graham played a major role in thediscovery and medical application of bisphosphonates.Professor John Kanis established the first Metabolic BoneUnit in Sheffield and now heads the WHO CollaboratingCentre for Metabolic Bone Diseases - responsible fordeveloping a fracture prediction tool (FRAX) that iswidely used internationally. In 1995 Professor RichardEastell opened a dedicated Osteoporosis Centre; theUniversity of Sheffield now has one of the world’s toposteoporosis research centres.The Mellanby Centre for Bone Research was the jointinspiration of its first and current directors, ProfessorsPeter Croucher and Richard Eastell; this jointappointment of basic and clinical researchers emphasisesthe importance of a translational approach to bonediseases. Clinical research includes: metabolic bonediseases such as osteoporosis (Professors Richard Eastell,Eugene McCloskey); childhood bone diseases (ProfessorNick Bishop); tumour-induced bone diseases (ProfessorsPeter Croucher, Rob Coleman and Eugene McCloskey);osteoarthritis and rheumatoid arthritis (Mr MarkWilkinson, Professor Gerry Wilson).Clinical research is underpinned by world-class basicbiomedical research; including new appointments(Professor Tim Skerry, Drs Ilaria Bellantuono, AllieGartland) and the relocation of all laboratory activities toone floor of the newly refurbished Henry WellcomeLaboratories in the Medical School. These laboratoriescontain the latest automated immunoassay analysers,high resolution microCT imaging equipment and theequipment to undertake quantitative dynamic bonehistomorphometry. These enviable facilities arecomplemented by the NIHR funded Bone BiomedicalResearch Unit (Director, Professor Richard Eastell). Thetwo Sheffield clinical bone services merged in 2003 toform the current Metabolic Bone Centre (clinical lead DrNicola Peel) which is one of the largest NHS centres forthe management of bone disease; close integration withthe clinical research programme offers state of the artfacilities to patients.In endocrinology, Professor Donald Munro openedthe Clinical Sciences Centre in the 1970s, developing oneof the first bioassays for Graves’ disease. Endocrinologyhas always been strongly supported through basicscience: Professors Chester Jones and Ian Henderson(comparative endocrinology), Professor Barry Brown andDr Pauline Dobson (intracellular signalling pathways). OnDonald’s retirement, Tony Weetman was appointed asProfessor of Medicine in 1991; since then Sheffield hasbecome one of the largest endocrine centres in the UK.18 T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

University of SheffieldThe Academic Unit of Diabetes, Endocrinology andMetabolism is now centralised on ‘O’ floor of the RoyalHallamshire Hospital site, commanding a view down theDon valley which fifty years ago was a haze of smoke andfire from the steel furnaces and is now a flourishingbusiness park. The laboratories are co-located with therecently opened Clinical Research Facility, close to theinpatient and outpatient endocrine facility on ‘Q’ floorwhich provides an ideal setting for translational research.The backbone for endocrine research in Sheffield is thevery large patient base, 3 million, and the critical mass ofendocrinologists. This has led to the development ofspecialist clinics, some of which are unique to Sheffield.The Pituitary Clinic (Professor Richard Ross, Drs WilliamBennet, John Newell-Price, Jonathan Webster) is supportedby surgeons Mr Showkat Mirza and Mr Saurabh Sinha.Endocrine surgery is blessed with two surgeons,Mr Sabapathy (Saba) Balasubramanian and Mr BarneyHarrison, leading the UK in laparoscopic adrenal surgery.Sheffield established the first UK Stereotacticradiosurgery service, while much of the early work onsomatostatin analogues and carcinoid tumours wasinitiated by Prof Frank Woods who brought his carcinoidinterest from Oxford; the carcinoid clinic has over 130patients (Professor Nigel Bax, Dr John Newell-Price).Paediatric endocrinology in Sheffield was established inthe 1970s by the late David Milner who was renowned,with Dr David Hill, for his work on pancreaticdevelopment and human growth hormone. He wassucceeded in 1989 by Dr Jerry Wales, one of the firstpaediatric specialists to be trained outside of London.Since then the team has expanded to include Dr PaulDimitri and Dr Neil Wright. Sheffield is renowned for itspaediatric to adult transitional clinics and appointed thefirst consultant in late effects, Dr Helena Davies, who hadtrained both in endocrinology and oncology and led thedevelopment of the Late Effects Group in Sheffield(LEGS). Sadly Helena had to retire early but the currentlate effects service in Sheffield boasts a Nurse Consultant(Dr Diana Greenfield), a Nurse Specialist (Ms TanyaUrqhart), four endocrinologists (Professor Richard Ross,Drs Paul Dmitri, Anna Jenkins, Jennie Walsh), and theHead of Obstetrics & Gynaecology Professor Bill Ledger.The excellence of the clinical services is based around theteam of Endocrine Nurse Specialists (Ms Kay Dunkley, MsVicky Ibbotson, Ms Betty Roberts) supported by multidisciplinaryteam (MDT) coordinators (Ms EmmaHoward, Ms Helen Sutcliffe) who manage a weeklyendocrine MDT and alternate week pituitary andneuroendocrine tumour MDTs. This providesan ideal setting for training and education.Current endocrine research in Sheffield isfocused, amongst other areas, around thethyroid, pituitary and adrenal. Thyroid research(Professor Tony Weetman, Drs Helen Kemp, PhilWatson) has been exploring antibody – antigeninteractions in autoimmune thyroiditis andrelated disorders like vitiligo, as well as theimmunogenetic basis for these conditions.Pituitary research (Professor Richard Ross, DrsSarb Pradnanhanga, Ian Wilkinson) has had afocus on growth hormone and pituitaryhormone replacement with the development oflong-acting growth hormone analogues toprovide once monthly therapy in growthhormone deficiency and acromegaly. In theadrenal setting, the work of Dr John Newell-Price is being translated into clinical benefitsand novel therapies for patients with Cushing’sand cortisol-excess. Sheffield has proved afertile environment for spin-doctors and theDepartment of Human Metabolism has fourspinout companies, two of which areendocrine: Asterion Ltd and Diurnal Ltd.Asterion has undertaken the commercialdevelopment of long-acting growth hormoneagonists and antagonists whilst Diurnal has aprogram developing a modified releaseformulation of hydrocortisone, Chronocort, forthe treatment of adrenal insufficiency(specifically congenital adrenal hyperplasia).Anyone visiting Sheffield is struck by thenumber of young people and the proximity tothe Peak District. The two Universities have astudent population of over 35 000, whouniversally love Sheffield: more graduatesremain in Sheffield than any other UK universitycity. A key reason for this loyalty is the easewith which you can get out of the city; most ofus can as readily walk from home to work asinto the countryside.If you ask anyone what they know about Sheffieldthey will usually mention three things: steel, football andThe Full Monty. In this spirit, we have attempted to bareall to you and we hope you have enjoyed your visit. Wewish you a safe onward journey and that, like many ofour graduates, the next time you visit, you will stay.RICHARD ROSSRichardRossRichardEastellJohnNewell-PriceJonathanWebsterJenniferWalshTonyWeetmanT H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 119

Age of austerity hits universitiesThe Higher Education Sector has been singled outfor tough treatment in the comprehensive spendingreview, particularly in England. The Higher EducationFunding Council for England (HEFCE) budget forteaching has been slashed. While Science, Technology,Engineering, and Mathematical (STEM) subjects willenjoy some protection and many universities arefrantically seeking sponsorship to supportscholarships, the vast majority of undergraduatestudents will be facing annual fees in the region of£6000–9000 from 2012. Universities will be required tobe more transparent about their degree programmesand the employment prospects they offer, there arealso calls for tighter regulation through the QualityAssurance Agency (QAA). ‘More for less’ is the callfrom the government. For those at the coalface, thisscenario will certainly pose new challenges – morebureaucracy, an inevitable drive for efficiency savings,and more demanding students expecting (notunreasonably) good value for their money.Curiously, little has been said publically about master’scourses, which are currently funded from the same HEFCEpot as undergraduate programmes and are, if anything, evenmore expensive to run, particularly in the STEM subjects.Universities may well wish to hike their fees for these coursesaccordingly; however, if they do, they may price themselvesout of the home market as any extension of the student loansystem to postgraduate education seems unlikely. This, inturn, could have a serious impact on the pool of studentseligible for PhD places, particularly as universities increasinglyrequire a master’s qualification to ensure Bologna compliance(the Bologna Process seeks to make academic degreestandards more comparable and compatible across Europe).At first reading, things sound brighter on the researchfront – certainly the maintenance of science researchbudget was a welcome surprise. However, it is not all abed of roses. In reality the science budget will be flat overthe next four years while inflation rises (current consumerprice index 3.7%) – this is a significant cut in real terms.Infrastructure will also be hit with a drop in the capitalbudgets of both the Research Councils and HEFCE. Fulleconomic costing (FEC) rates will also fall in the light ofthe Wakeham review, but the savings made by theResearch Councils will be directed to research which isgood news for researchers, if not for their institutions.Inevitably the winners in this new climate will be thosewho find new ways of doing things – Darwinism or AnimalFarm, however you choose to view it! Where are theopportunities for endocrinologists and how can the Societyhelp its members maximise these opportunities? Withrespect to teaching and education, the results of our recentmember survey requested the Society do more to supporteducation for scientists, clinicians and nurses by, forexample, the provision of online material. Could we gofurther and produce a core set of teaching resources whichcould be readily downloaded by those delivering orreceiving undergraduate and postgraduate teaching in ouruniversities and hospitals? We would need commitmentfrom experts in the various subfields to ensure that thematerial was kept up to date but the upshot would be aninvaluable high quality resource which would not onlysupport those delivering and taking the courses but alsohelp students appreciate just how exciting endocrinology is.With respect to research, the door is open forendocrinology. The MRC, Wellcome Trust and othercharities invest heavily in this area. The BBSRC strategic planfocuses strongly on the healthy organism (not disease whichis the remit of the MRC) and food security, both of whichare rich picking grounds for endocrinologists, while theEPSRC offers opportunity to break new ground at theinterface between engineering and the physical and lifesciences. The funding letter from the Department ofBusiness, Innovation and Skills to the Research Councilsemphasises investing in world-class science and promotingimpact to support the economy. Much is made ofconcentrating resources for research and research trainingon ‘research centres of proven excellence with critical massand multidisciplinary capacity’. A further emphasis is onpartnership both between universities, and betweenuniversities, research council institutes and the private sector.The Research Assessment Exercise did much toenhance research in the UK, but as league tables gainedmomentum universities increasingly competed againsteach other. As we move to an era of big grants supportingbig science we need to move away from such tribalism –partner or perish will be the mantra of the future. I thinkthat the UK should be proud of its endocrinology – onlyby working collectively will we capitalise on our expertise,rise to the new funding challenges, take our disciplineforward and protect our talented young researchers.If you have ideas as to how the Society can help, doplease let us know (info@endocrinology.org). We areundertaking a strategic review of our activities in thesummer and any suggestions you put forward will be fedinto this process.JULIA BUCKINGHAM20 T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 1

The Struggle for ExistenceChanges to the research environment are aninevitable consequence of the election of a newgovernment; we are beginning to see how thesechanges will manifest themselves. In the last issuewe reported that science had, in having itsbudget frozen, faired relatively well. This may bethe case in direct funding but large cutselsewhere, particularly to universities and capitalspending, can still affect science.Thankfully, the Conservative party pre-electioncommitment to medical research has been honouredthrough the transfer of budgetary responsibility forthe new UK Centre for Medical Research to theDepartment of Health, which has been protectedfrom spending cuts.Even so, the Campaign for Science andEngineering (CaSE) has warned that cuts of over 40%to capital spending will mean that funding for facilities,maintenance and other long-term commitments willhave to be taken from money for research grants.Furthermore, large scale cuts to University funding willhave a huge impact on science.Monetary concerns aside, other developments inscience policy include the Rawlins review of theregulation and governance of health research,conducted by the Academy of Medical Sciences. Thereview calls for a single body – a Health ResearchAgency – to conduct a streamlined approach to theregulation of research, following concerns that thecomplex and bureaucratic system currently in place isstifling progress (the full report can be found atwww.acmedsci.ac.uk/p47.html). The Health SecretaryAndrew Lansley recently led a cull of regulatoryauthorities, including the Human Fertilisation andEmbryology Authority: the scientific communityshould watch these developments closely.The Wellcome TrustThe changes to Wellcome Trust funding for science havebeen well publicised … but for any member not on theWellcome roadshow tour, here is a brief overview:The Wellcome Trust is moving away from funding a largenumber of medium-term project and programme grantstowards Wellcome Trust ‘Investigator Awards’.The project and programme grant scheme often tiedresearchers into a cycle of focusing on securing grants ratherthan devoting themselves to their research. The new initiativebuilds on the Trust's highly successful fellowship schemes, whichprovide funding for scientists at all stages of their careers,providing the flexibility and length of tenure necessary to tackleimportant research questions. The initiative is now alsoextended to researchers who are salaried by their university orresearch institute.Funding is now flexible in both length and scale: awards ofup to £425 000 per year for up to seven years can be madedepending on the researcher, and the resources that will berequired to realise their research goals. Funding is available toresearchers at all career stages.At the point of application, researchers will no longer beexpected to provide a detailed methodological description oran exact budget. The application form will ask researchers tooutline their research vision, what their approach toanswering their key research questions will be, and theapproximate costs involved.Applications will be shortlisted by the Trust’s ‘ExpertReview Groups’, formed by independent research scientistsfrom the UK and overseas. These groups will assess the vision,ambition and track record of each applicant and the potentialfor success. Shortlisted applications will be sent out to peerreview by referees. Applicants will then be invited to interview,where they will be given the opportunity to present their case.Further details and applications for Investigator Awards canbe made here: www.wellcome.ac.uk/Funding/ Biomedicalscience/Funding-schemes/Investigator-Awards/index.htmBiotechnology and Biological Sciences Research CouncilThe Biotechnology and Biological Sciences Research Council (BBSRC) is one of the seven Research Councilsthat comprise Research Councils UK (RCUK). The RCUK is funded from the Government's Department forBusiness, Innovation and Skills (BIS); like every government department, the spectre of budget cuts looms large.We asked Professor Douglas Kell, BBSRC Chief Executive, what the outcome for bioscience funding looked like inthe wake of the comprehensive spending review:‘Given the current pressure on public finances in the UK, our allocation of almost £1.5 billion over the next fouryears is an excellent outcome for bioscience. This represents a 3% fall in our programme budget to £351 million in2014/15 compared to our baseline of £362 million in 2010/11. As with other research councils our capital budget hashad to reduce significantly – in BBSRC’s case from a baseline of £60 million in 2010/11 to £30 million in 2014/15. Theredevelopment of the Pirbright Laboratory of BBSRC’s Institute for Animal Health is proceeding with a further £37million of funding from the Large Facilities Capital Fund.We will need to make further efficiency savings and will be working with our community of researchers to ensurethat we extract maximum value from our investments. I remain confident that we will be able to maintain the UK’sworld-class research base in bioscience.In particular we will be focusing on our priority science areas of Global Food Security, Industrial Biotechnology andBioenergy, and Bioscience Underpinning Health and Wellbeing. This will include, for example, preparing for an ageingpopulation and maintaining wellbeing through improved understanding of the basic biological mechanisms underlyinghealthy physiology. For more details please see www.bbsrc.ac.uk’T H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 121

Journal of EndocrinologyANNOUNCING …RapidCommunicationsfor original, high impact researchIn an excitingnew developmentJournal of Endocrinologyis now publishingRapid Communications.Reviewed and publishedonline in as little as twoweeks from submission!Original, high impact researchpapers representing significantadvances in endocrine science.Rapid Communications will benefit from fast formal peer review and, ifaccepted, the paper will move rapidly to online publication within twoweeks followed by print publication in the next available issue.Author guidelines can be found at http://joe.endocrinology-journals.org/To submit your paper to Rapid Communications please send an abstractand covering letter explaining the need for rapid communication to theEditor-in-Chief. Email: joe@endocrinology.org

Hot TopicsJournal of EndocrinologyProlactin and atherosclerotic plaquesCardiovascular disease and prolactin have been linked.Reuwer and colleagues investigated the role of prolactinand its receptor in the inflammatory response of humancarotid atherosclerotic plaques: they found the plaquescontained mRNA of the prolactin receptor but not theligand. The receptor was most abundant in the plaqueshoulder regions, and in macrophages embedded in theplaques. This may aggravate local inflammation.Read the full article in Journal of Endocrinology 208 107–117Combination therapy in cancer cachexiaCancer cachexia has a multifactorial pathogenesis,including loss of weight, muscle atrophy and loss ofappetite. Chen & Qiu studied the effects of differentcombinations of growth hormone, insulin andindomethacin in a murine cancer cachexia model. Theyfound that combination therapy with these agentsalleviated cachexia and noted an increase in survival,indicating that a combination therapy targeting differentpathogenic mechanisms has great therapeutic potential.Read the full article in Journal of Endocrinology 208 131–136Novel thiazolidinedione mechanismThiazolidinediones (TZDs) are prescribed in type 2diabetes as an anti-atherogenic. Hu and colleagues reportthat NUR77, an orphan nuclear receptor, exhibitsincreased mRNA expression when stimulated by TZDs andthat TZDs inhibit this receptor by a peroxisomeproliferator-activated receptor g (PPAR-g)-independentmolecular mechanism, alongside inhibited NUR77promoter activity, suggesting a TZD transcriptional effecton mRNA expression. These findings could contribute tothe design of future atheroprotective agents.Read the full article in Journal of Endocrinology 208 R1–R7Endocrine-Related CancerMultikinase inhibitors and thyroid cancerMedullary thyroid cancers (MTCs) frequently feature somaticRET mutations. Vitagliano and colleagues studied themechanism of action of tyrosine kinase inhibitor vandetanibin human MTC cells with oncogenic RET mutations. Theyfound that vandetanib reduced cell proliferation, inhibitedphosphorylation of the Shc/MAPK pathway, and inhibitedvascular endothelial growth factor receptor and epidermalgrowth factor receptor kinases. This suggests that vandetanibsimultaneously inhibits multiple kinases.Read the full article in Endocrine-Related Cancer 18 1–11PPGL catecholamine phenotypeEisenhofer and colleagues retrospectively analysed catecholaminebiomarkers in patients with phaeochromocytomaand paragangliomas (PPGLs). Patients with PPGLs due tomultiple endocrine neoplasia type 2 and neurofibromatosistype 1 tumours had a distinct phenotype compared tothose with von Hippel-Lindau and succinate dehydrogenasegene mutations. The authors suggest that the differencesmay result from different tumour progenitors: immaturenoradrenergic or dopaminergic chromaffin progenitor cells,or highly differentiated adrenergic chromaffin cells.Read the full article in Endocrine-Related Cancer 18 97–111JOURNAL OFMOLECULAR ENDOCRINOLOGYPPAR-g and aldosterone productionAldosterone is a factor in atherosclerosis andhypertension. The role of peroxisome proliferatoractivatedreceptor-g (PPAR-g) in aldosterone production isunclear. Uruno and colleagues found that overexpressionof PPAR-g resulted in suppression of aldosterone secretionand reduced expression of the aldosterone synthase geneCYP11B2. Calcium/calmodulin-dependent protein kinase 1stimulates CYP11B2 transcriptional activity and issuppressed by PPAR-g. This sheds light on why PPAR-gagonists are effective in hypertension.Read the full article in Journal of Molecular Endocrinology46 37–49Apelin stimulates glucose uptakeActivation of AMP-activated protein kinase (AMPK) is used inthe treatment of obesity-associated disorders such as type 2diabetes mellitus. Attané and colleagues have shown, for thefirst time, that apelin stimulates AMPK phosphorylation inhuman adipose tissue. Apelin administration did not effectlipolysis, but stimulated glucose uptake in human adiposetissue explants. As such, the apelin-signalling pathway is apromising therapeutic target.Read the full article in Journal of Molecular Endocrinology46 21–28Clinical EndocrinologyComparing radionuclide imaging methodsCharrier and colleagues evaluated non-metastatic extraadrenalparagangliomas using two imaging methods:[18F]FDOPA-PET and [111In] pentetreotide-SPECTsomatostatin receptor scintigraphy (SRS). [18F]FDOPA-PETappeared to be the most reliable diagnostic tool,detecting 39 of 45 lesions. Both scans detectedsignificantly more head and neck lesions than abdominallesions. The study concluded that [18F]FDOPA-PET shouldreplace SRS as the first-line imaging procedure.Read the full article in Clinical Endocrinology 74 21–29Subclinical thyrotoxicosisIn this retrospective study Schouten and colleaguessought the point at which subclinical thyrotoxicosis (SCT)progresses to overt hyperthyroidism, and to identify therisk factors associated with progression. Of the risk factorsassessed, underlying thyroid pathology was the onlyindependent predictor of outcome. They found a 5–8%rate of disease progression, with a high rate ofhyperthyroidism found in patients with autonomousnodules. This study could assist in the preparation ofguidelines on when individuals with SCT should betreated for overt disease.Read the full article in Clinical Endocrinology 74 257–261Thyroxine dose predictionThe initial thyroxine replacement dose after totalthyroidectomy is often calculated purely by bodyweight;the dose is then titrated to the individual patient.Optimising therapy in each patient can be timeconsuming. Mistry and colleagues report a simplecalculated regression equation which more accuratelypredicts the optimal initial thyroxine replacement dose.More accurate dose prediction could help save time andresources, while increasing control and patient satisfaction.Read the full article in Clinical Endocrinology 74 384–387Society membersget free accessto Journal ofEndocrinology,Journal ofMolecularEndocrinologyand Endocrine-Related Cancer viawww.bioscialliance.orgT H E E N D O C R I N O L O G I S T • I S S U E 9 9 • S P R I N G 2 0 1 123

Will it be easy to do?NEWGenotropin (somatropin, rbe)pre-filled penPre-filledPre-settablePredictableTo find out more, please call 0800 521249Whatever their concerns, make sure they’renot about growth hormone therapysomatropin (rbe)Genotropin ® (somatropin, rbe). Abbreviated Prescribing InformationGenotropin 5.3 mg Pre-filled pen (GoQuick). Genotropin 12 mg Pre-filled pen.(GoQuick) Genotropin 5.3 mg Two chamber cartridge. Genotropin 12 mg Twochamber cartridge. Genotropin MiniQuick 0.2 mg. Genotropin MiniQuick 0.4 mg.Genotropin MiniQuick 0.6 mg. Genotropin MiniQuick 0.8 mg. GenotropinMiniQuick 1 mg. Genotropin MiniQuick 1.2 mg. Genotropin MiniQuick 1.4 mg.Genotropin MiniQuick 1.6 mg. Genotropin MiniQuick 1.8 mg. GenotropinMiniQuick 2 mg. Please refer to the SmPC before prescribing Genotropin. Presentation:Genotropin Pre-filled Pen (GoQuick): Two-chamber cartridge sealed in a disposablemultidose pre-filled pen GoQuick. The cartridges contain either 5.3 mg or 12 mg somatropin(rbe). Each cartridge also contains 0.3% metacresol as preservative. The 5.3 mg pre-filled penGoQuick is colour coded blue. The 12 mg pre-filled pen GoQuick is colour coded purple.Genotropin Cartridge: Two-chamber cartridge for use in a re-useable injection device,Genotropin pen, or in a reconstitution device. The cartridges contain either 5.3 mg or 12 mgsomatropin (rbe). Each cartridge also contains 0.3% metacresol as preservative. The GenotropinPens are colour coded, and must be used with the matching colour coded Genotropin twochambercartridge to give the correct dose. The Genotropin Pen 5.3 (blue) must be used withGenotropin 5.3 mg cartridge (blue). The Genotropin Pen 12 (purple) must be used withGenotropin 12 mg cartridge (purple). Instruction on reconstitution plus use of devices is suppliedseparately as are the Pen and Genotropin Mixer devices and any necessary consumables.Genotropin MiniQuick: Two compartment cartridge in single dose syringe containing powderand solvent for injection together with an injection needle. Each device contains either 0.2 mg,0.4 mg, 0.6 mg, 0.8 mg, 1 mg, 1.2 mg, 1.4 mg, 1.6 mg, 1.8 mg or 2 mg somatropin (rbe).Indications: Children: Treatment of growth disturbance due to insufficient secretion ofgrowth hormone (growth hormone deficiency, GHD) or associated with gonadal dysgenesis(Turner Syndrome) or chronic renal insufficiency (CRI) or in short children born Small forGestational Age (SGA) with a birth weight and/or length below –2SD, who failed to show catchupgrowth by 4 years of age or later. Prader-Willi syndrome (PWS), for improvement of growthand body composition. The diagnosis of PWS should be confirmed by appropriate genetic testing.Adults: Replacement therapy in adults with pronounced GH deficiency. Adult onset: Patientswho have severe growth hormone deficiency associated with multiple hormone deficiencies as aresult of known hypothalamic or pituitary pathology and who have at least one known deficiencyof pituitary hormone not being prolactin. Childhood Onset: Patients who were growth hormonedeficient during childhood as a result of congenital, genetic, acquired, or idiopathic causes.Dosage and Administration: Dose should be personalised for each individual. Thesubcutaneous injection site should be varied to prevent lipoatrophy. Insufficient Secretion ofGH in children: 0.025–0.035 mg/kg body weight day. Higher doses have been used. Wherechildhood onset GHD persists into adolescence, treatment should be continued to achieve fullsomatic development (e.g. body composition, bone mass). For monitoring, the attainment of anormal peak bone mass defined as a T score > −1 (i.e. standardised to average adult peak bonemass measured by dual energy X-ray absorptiometry taking into account sex and ethnicity) is oneof the therapeutic objectives during the transition period. Prader-Willi Syndrome:0.035 mg/kg body weight per day. Daily doses of 2.7 mg should not be exceeded. GonadalDysgenesis (Turner Syndrome): 0.045–0.050 mg/kg body weight per day. CRI: A doseof 0.045–0.050 mg/kg body weight per day. Higher doses can be needed if growth velocity istoo low. Dose correction can be needed after 6 months treatment. Short children born SGA:0.035 mg/kg body weight per day until final height is reached. GH Deficient Adults: Inpatients who continue growth hormone therapy after childhood GHD, the recommended dose torestart is 0.2–0.5 mg per day. The dose should be gradually increased or decreased according toindividual patient requirements as determined by the IGF-I concentration. In patients with adultonsetGHD, start with low dose, 0.15–0.3 mg/day. The dose should be gradually increased asdetermined by the IGF-1 concentration. Clinical response and side effects may guide dosetitration. It is recognised that there are patients with GHD who do not normalise IGF-I levelsGEN3243A Date of preparation: January 2011despite a good clinical response, and thus do not require dose escalation. The maintenance doseseldom exceeds 1.0 mg per day. Women (especially those on oral oestrogen) may require higherdoses than men. As normal physiological growth hormone production decreases with age, doserequirements are reduced. In patients above 60 years, therapy should start with a dose of0.1– 0.2 mg per day and should be slowly increased according to individual patient requirements.The minimum effective dose should be used. The maintenance dose in these patients seldomexceeds 0.5 mg per day. Contra-indications, Warnings etc: Hypersensitivity to the activesubstance or to any of the excipients. Any evidence of tumour activity exists. Anti-tumourtreatment must be complete. Genotropin should not be used for growth promotion in childrenwith closed epiphyses. Patients with acute critical illness suffering complications following openheart surgery, abdominal surgery, multiple accidental trauma, acute respiratory failure or similarconditions should not be treated with Genotropin. Hypersensitivity to the active substance or toany of the excipients. Precautions: Diagnosis and therapy should be initiated and monitored bysuitably qualified and experienced doctors. Somatropin may induce insulin sensitivity and insome patients diabetes mellitus. Patients with diabetes, glucose intolerance, or additional riskfactors for diabetes should be monitored closely during somatropin therapy. As thyroid functionmay be affected, monitoring of thyroid function should be conducted in all patients. In patientswith hypopituitarism on standard replacement therapy, the potential effect of growth hormonetreatment on thyroid function must be closely monitored. Signs of any relapse of malignantdisease should be monitored. In patients with endocrine disorders, slipped epiphyses of the hipmay occur. In case of severe or recurrent headache, visual problems, nausea and/or vomiting, afunduscopy for papilloedema is recommended as some rare cases of benign intracranialhypertension have been reported and if appropriate treatment should be discontinued. Leukaemiahas been reported in a small number of growth hormone deficiency patients, some of whom havebeen treated with somatropin. However, there is no evidence that leukaemia incidence isincreased in growth hormone recipients without predisposition factors. As with all somatropincontaining products, a small percentage of patients may develop antibodies to GENOTROPIN. Thebinding capacity of these antibodies is low and there is no effect on growth rate. Testing forantibodies to somatropin should be carried out in any patient with otherwise unexplained lack ofresponse. Experience in patients above 80 years is limited. Elderly patients may be moresensitive to the action of Genotropin, and therefore may be more prone to develop adversereactions. In acute, critically ill adult patients, GH may increase mortality. In CRI, renal functionshould be below 50% of normal before institution of therapy and growth should be followed fora year preceding institution of therapy. Conservative treatment for renal insufficiency shouldhave been established and be maintained during therapy. Discontinue GH after renaltransplantation. There have been reports of fatalities associated with the use of growth hormonein paediatric patients with Prader-Willi syndrome who had one or more of the following riskfactors: severe obesity (those patients exceeding a weight/height of 200%), history ofrespiratory impairment or sleep apnoea, or unidentified respiratory infection. Patients with oneor more of these factors may be at increased risk. Before initiation of treatment with somatropinin patients with Prader-Willi syndrome, signs for upper airway obstruction, sleep apnoea, orrespiratory infections should be assessed. Patients should be monitored for signs of respiratoryinfections, which should be diagnosed as early as possible and treated aggressively. All patientswith Prader-Willi syndrome should also have effective weight control before and during growthhormone treatment. Scoliosis is common in PWS and signs for scoliosis should be monitored.Experience of prolonged therapy in adults and patients with PWS is limited. In short children bornSGA other medical reasons or treatments that could explain growth disturbance should be ruledout before starting treatment. Not recommended to initiate treatment in SGA patients near onsetof puberty. Interactions: Concomitant treatment with glucocorticoids may inhibit the growthpromotingeffects of somatropin containing products. Therefore, patients treated withglucocorticoids should have their growth monitored carefully to assess the potential impact ofglucocorticoid treatment on growth. The clearance of compounds metabolised by cytochromeP450 3A4 (e.g. sex steroids, corticosteroids, anticonvulsants and ciclosporin) may be increasedresulting in lower plasma levels of these compounds. The clinical significance of this is unknown.In diabetes mellitus, insulin dosage may need adjustment. Somatropin has been reported toreduce serum cortisol levels, possibly by affecting carrier proteins or by increased hepaticclearance. The clinical relevance of these findings may be limited. Corticosteroid replacementtherapy should be optimised before initiation of Genotropin therapy. Pregnancy andLactation: Animal studies are insufficient with regard to effects on pregnancy, embryofoetaldevelopment, parturition or postnatal development. There are no clinical studies available onexposed pregnancies. Therefore, somatropin containing products are not recommended duringpregnancy and in women of childbearing potential not using contraception. There have been noclinical studies conducted with somatropin containing products in breast-feeding women. It is notknown whether somatropin is excreted in human milk, but absorption of intact protein from theinfant GI tract is unlikely. Therefore caution should be exercised when somatropin containingproducts are administered to breast-feeding women. Overdosage: Acute overdosage couldlead initially to hypoglycaemia and subsequently to hyperglycaemia and Long-term overdosagecould result in signs and symptoms consistent with the known effects of human growth hormoneexcess. Side Effects: In adult patients, common adverse effects related to fluid retention; suchas peripheral oedema, stiffness in the extremities, paraesthesia, arthralgia and myalgia. Theseeffects are mild to moderate, arise within the first months of treatment and subside spontaneouslyor with dose reduction. Formation of antibodies of low binding capacity in approximately 1% ofpatients; in vitro chromosome aberrations of unknown clinical significance. Very rare cases(< 1/10,000) of leukaemia have been reported in GH deficient children treated with somatropin,but the incidence appears to be similar to that in children without GH deficiency. In Prader-WilliSyndrome patients treated with somatropin rare cases of sudden death have been reported,although no causal link has been established. Pharmaceutical Precautions: KeepGenotropin in the outer carton to protect from light. Before reconstitution: store in therefrigerator (2–8ºC). Genotropin Miniquick: Solely for ambulatory use, only, the product may bestored at or below 25ºC by the end user for a single period of not more than 6 months. Duringand/or at the end of this 6 months period, the product should not be put back in the refrigerator.Genotropin Cartridge: Storage up to 1 month at or below 25ºC allowed. After reconstitution:Genotropin Miniquick: Use immediately or within 24 hours. Genotropin Cartridge: Store in arefrigerator (2ºC–8ºC), do not freeze. Keep the container in the outer carton in order to protectfrom light. Use within 4 weeks. Legal Category: CD (Sch 4, Part I), POM. Pack/Basic NHSPrice/PL No: Genotropin 5.3 mg Pre-filled pen (GoQuick) x 1 £122.87 00022/0085.Genotropin 12 mg Pre-filled pen (GoQuick) x 1 £278.20 00022/0098. Genotropin 5.3 mg Twochamber cartridge x 1 £122.87 00022/0085. Genotropin 12 mg Two chamber cartridge x 1£278.20 00022/0098. Genotropin MiniQuick 0.2 mg x 7 £32.46 00022/0186. GenotropinMiniQuick 0.4 mg x 7 £64.91 00022/0187. Genotropin MiniQuick 0.6 mg x 7 £97.3700022/0188. Genotropin MiniQuick 0.8 mg x 7 £129.82 00022/0189. Genotropin MiniQuick1 mg x 7 £162.28 00022/0190. Genotropin MiniQuick 1.2 mg x 7 £194.74 00022/0191.Genotropin MiniQuick 1.4 mg x 7 £227.19 00022/0192. Genotropin MiniQuick 1.6 mg x 7£259.65 00022/0193. Genotropin MiniQuick 1.8 mg x 7 £292.11 00022/0194. GenotropinMiniQuick 2 mg x 7 £324.56 00022/0195. PL Holder: Pharmacia Laboratories Limited,Ramsgate Road, Sandwich, Kent, CT13 9NJ, UK. Further information is available on request fromMedical Information Department at Pfizer Limited, Walton Oaks, Dorking Road, Tadworth,Surrey, KT20 7NS, UK. Date of preparation: August 2010. Company reference:GN20_0Adverse events should be reported.Reporting forms and information can be foundat www.yellowcard.gov.uk. Adverse events should alsobe reported to Pfizer Medical Information on 01304 616161.